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I i, <br /> v Y� <br /> r . S NJ aQ Environmental Health Department <br /> .� COUNTY <br /> • ' Greatness graves here- <br /> 10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day,maintain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> rigerated truck ❑ lcekllh and tubs <br /> %Owuher(specify) <br /> 11, 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach,and wiping cloths(cleaning towels)_ <br /> ❑Tub to store wiping cloths in bleach solution. <br /> 12. '1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ❑ Water supply dispenser with warm water at a minimum of 100*F (i.e. 5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin)for the collection of Onselwastewater. <br /> ❑ Paper towels and pump-style soap container. <br /> 13. N of ursons to be present in booth during all hours of operation: <br /> **Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br /> pr ration for this event. A copy of this checklist must be in the booth at all hours of <br /> pr -ratio and operation. Re um original to festival coordinator three weeks Prior to <br /> even <br /> 14. Completed by: r, (IA-, <br /> Sig rtlye - Tifie - ate <br /> s-.rr Get. 4lv <br /> Health PermitP Hanc"�h w1_ <br /> StetnornY�aCfcrr� -- <br /> Dih Paper Band Towels <br /> Sow dispmsa <br /> Gutting Board Ssmtmel budcet- <br /> bleach 6 water for <br /> Pmpm 5tme <br /> Blcach Morino wging dn[hx <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Prooanc Talc -- ——_ ---— <br /> Soap and Water Rinse wour Bleach and Plater Garbage <br /> Can <br /> Fire F�tongWstaer <br /> WAter <br /> Ice Cooler 5 Gal Band wash <br /> Extm kv Baps 4 Food Gwmavwv'must be wask omsm Contaltaer <br /> sAynadG ixJaes aN off gramd! <br /> 1868 E_ Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 j www-sjgov.orglehd <br /> • EHD 1 Fr02 Page Bat 11 TEMP EVENT APP <br /> 05M 19 <br />